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General NPI Number Information
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NPI Number | 1457816043
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Entity Type | Organization
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Legal Business Name | MAX POTENTIAL BEARDEN, LLC
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Dates
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Enumeration Date | 02/07/2019
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 8239 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-5448
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Country | US
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Telephone | 865-500-8500
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Fax | 865-500-8502
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Provider Business Mailing Address
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Address Line | 8239 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-5448
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Country | US
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Telephone | 865-500-8500
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Fax | 865-500-8502
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT BENEDICT
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Credential |
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Telephone | 865-500-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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